Abstract

Introduction Most HIV diagnoses in Australia occur in gay and bisexual men (GBM), however the majority of higher-risk GBM are testing for HIV at less than recommended frequency (3–6 monthly). In recent years, public sexual health clinics (SHCs) have implemented a range of initiatives to increase access to HIV testing in GBM including express clinical models, after-hours/drop-in services, online-booking, rapid-testing, and SMS reminders. We measured HIV testing trends among GBM at New South Wales (NSW) SHCs in the time period of the initiatives.

Methods We utilised routinely collected data from 33 SHCs in NSW, and calculated the following annual indicators among HIV negative GBM from 2009–2013: number attending clinics; proportion tested for HIV at least once; proportion re-tested within 1–12 months; and HIV positivity. Indicators were calculated for all GBM and higher-risk GBM (>5 partners in last 3 months or previous sexually transmissible infection diagnosis). Chi-square tests were used to assess trends over time.

Results In the 5-year period, 29,623 unique HIV-negative GBM attended participating SHCs and 21% were higher-risk men. Among all HIV-negative GBM, there were significant increasing trends (p-values <0.001) in: the number of individuals attending (4,748 in 2009 to 7,387 in 2013, relative increase:56%); proportion tested (73% to 85%, relative increase:16%); and proportion re-tested within 1–12 months (42% to 52%, relative increase:24%). Among higher-risk GBM, greater increases were observed in individuals attending (934 to 1,667, relative increase:78%) and proportion re-testing (51% to 64%, relative increase:26%), but a smaller change in the proportion tested (89% to 93%, relative increase:5%), though starting from a higher base (significant increasing trends, p-values <0.001). HIV-positivity in all GBM fluctuated (1.3–1.1%) with no significant trend over time (p = 0.790).

Conclusion NSW SHCs have successfully increased attendance and HIV testing among GBM, particularly in higher-risk men. HIV-positivity suggests that testing increases have been well-targeted to higher-risk GBM. There is potential to further improve testing uptake and re-testing.

Disclosure of interest statement ACCESS study is funded by the NSW Ministry of Health and the Victorian Department of Health.

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